The Combination of Market Prices and Public Health-Insurance [HT]

The book Bring Market Prices to Medicare argues that it can through a competitive bidding process to improve health care. The authors want beneficiaries to face the true price differentials between the lowest cost plans and less efficient plans, regardless if the plan is Medicare FFS or an MA plan. Another issue focuses on regional adjustments. Living in New York is expensive and health care is more expensive in New York than in rural Mississippi. However, should Medicare subsidize New Yorkers because their health care is more expensive. The authors argue no.  [HT]

● Bring Market Prices to Medicare: Essential Reform at a Time of Fiscal Crisis (AEI Studies on Medicare Reform), Robert F. Coulam, Roger Feldman, Bryan E. Dowd

The Effects of Entry and Exit (Turnover)

The dynamics of firms' entry and exit (if turnover rate and retention rate can be calculated like in a firm) will influence the competition, innovation, diffusion of advanced technology, and productivity. However, "The health care market exhibits important differences as compared to other markets, including various forms of market failure and, as a consequence, extensive market regulation. Thus, the economic effects of entries and exits in health care markets are less obvious. "

It is a very interesting topic to examine the economic effects of entry and exit in health care market. Martin in this paper attempted to establish a framework to study the impacts on the public-private and GP-specialists relationships. 

Source: Entry and Exit of Physicians in a two-tiered public/private Health Care System

预防医疗不省钱

It is well established that preventive care reduces the prevalence of disease and helps people live longer, healthier lives. Analysis of the cost-effectiveness of preventive care can guide policy-makers to allocate scarce resources. This synthesis reviews the evidence on the cost-effectiveness of clinical preventive care. Key findings include: although many preventive services are a good value (defined as costing less than $50,000 to $100,000 per Quality Adjusted Life Year), only a few, such as childhood immunizations and counseling adults on the use of low-dose aspirin are widely regarded as cost-saving. Costs to reduce risk factors, screening costs, and the cost of treatment when disease is found can offset any savings from preventive care. Prevention can reduce the incidence of disease, but savings may be partially offset by health care costs associated with increased longevity. Whether these additional competing risk costs outweigh the savings from avoiding the targeted disease depends on how healthy people are during the added life years. Given that so few preventive services save money and that these services are already in wide use, it is unlikely that prevention can reduce health care spending. The authors question whether the emphasis on savings is appropriate and suggest it is better to focus on high value preventive care, taking into account increased longevity and quality of life.

Source: Cost Savings and Cost-Effectiveness of Clinical Preventive Care

    Thus we must pay attention to the differences between cost-effectiveness and cost-saving of cares.

My favorite four HEALTH ECONOMISTS

Guy David, genius, I love his research.

David Meltzer, technically he is not so much young, but is still. Both Dav have particular interests in specialization. 

Almond, I have been attracted by issues with health shock and big famine. 

Chandra, so brilliant, "malpractice" expert, and be good at almost every field of health economics.

Intro to CCS for ICD-10

The Clinical Classifications Software (CCS) for ICD-10 is a diagnosis categorization scheme that can be employed in many types of projects analyzing data on diagnoses. This tool is based on the International Classification of Diseases, 10th Revision (ICD-10), a uniform and standardized coding system, which has been used in the U.S. for mortality reporting since 1999. The ICD-10's multitude of codes – more than 32,000 diagnosis codes in all – are collapsed into a smaller number of clinically meaningful categories (only 260 types) that are sometimes more useful for presenting descriptive statistics than are individual ICD-10-CM codes. 

CCS ICD-10 categories can be employed in many types of projects analyzing data on diagnoses. For example, they can be used to:

• Identify populations for disease-specific studies
• Gain a better understanding of the distribution of certain conditions across disease groupings
• Examine trends in mortality by broad diagnosis groupings.

Useful links:

Clinical Classifications Software (CCS) for ICD-10

History of CCS

Appendix A - Clinical Classification Software-DIAGNOSES


An NBER Paper:
Is the Foreclosure Crisis Making Us Sick?